Ronan Abgral et al. JIMG 2017;10:

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Presentation transcript:

Ronan Abgral et al. JIMG 2017;10:594-597 Chronic Myocardial Infarction Patient (50-year-old female) presented with congestive heart failure, without a history of coronary artery disease or chest pain. Echocardiography demonstrated severe left ventricular systolic impairment. LGE-CMR (A) image obtained in long-axis view showed transmural late enhancement of the anteroseptum. Matched FDG-PET (B) and fused FDG-PET/MR (C and D) images did not show any increased uptake in this territory (maximum standardized uptake value of LGE territory/blood pool uptake ratio = 0.8), indicating that this infarct was old. A 4-chamber cine CMR (E, Online Video 2) sequence demonstrated an anterior wall motion abnormality. Overall, left ventricular systolic function was moderately impaired (left ventricular ejection fraction = 40%). CMR T2 mapping (F) view (short-axis) was unable to clearly differentiate regions of increased inflammatory activity. Impression: The absence of increased PET uptake in the region of LGE, in the stated clinical context, was consistent with an old, silent myocardial infarction as the cause of the heart failure. Abbreviations as in Figure 1. Ronan Abgral et al. JIMG 2017;10:594-597 2017 American College of Cardiology Foundation